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HEALTH ANSWERS

Can badly fitting shoes damage feet?

Yes, and a new study, published this fall in the journal of the American Podiatric Medical Association, suggests that most people do indeed wear the wrong size shoe.

The study, which involved 440 veterans, most of them male, found that only 25 percent of participants wore correctly sized shoes. Men with diabetes -- which can lead to foot infections and amputations -- were five times more likely than others to have poorly fitting shoes. This is troubling because people with diabetes often have poor nerve sensation in the feet and can't notice cuts and ulcers that can become infected. The loss of sensation may make people less able to buy the right size shoe. Also, many people have one foot longer than the other, and often -- wrongly -- buy to fit the smaller foot, the study found.

At a minimum, badly fitting shoes can cause corns and calluses -- protective layers of dead skin caused by friction of shoes, said Dr. Joseph Caporusso , a McAllen, Texas, podiatrist who is chairman of public education for the Podiatric Medical Association. Poorly fitted shoes can also exacerbate hammertoes, a condition in which the toes are bent into a claw-like position. Bunions, misaligned big toe joints that can become swollen and tender, tend to run in families, but the tendency can be aggravated by too-narrow shoes, he said.

High heels, which throw the weight toward the front of the foot, can cause the Achilles tendon at the back of the ankle to shorten and disrupt the mechanics of walking, said Dr. Peter Paicos Jr., a podiatrist and associate medical director of the wound healing center at Winchester Hospital.

A shoe is supposed to be "a protective container," said Paicos. "But we spin fashion into it, so that changes what the container does." Badly fitting shoes may not pose a serious problem in young people, he added, but in older people who may already have trouble walking, they can make a bad situation worse.

JUDY FOREMAN

E-mail health questions to Foreman@globe.com.

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